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Anesthetics

Lung Ultrasound - guided Positive End Expiratory Pressure group

After endo-tracheal intubation; A PEEP of 4 cmH2O will be initially used till 5 min after pneumoperitoneum. Then The PEEP will be adjusted in a stepwise approach after performing bedside lung ultrasound. The PEEP will be increased by 2 cmH2O until no lung collapse is detected. Lung ultrasound will be repeated 5 min after every change in the PEEP with a maximal PEEP of 12 cmH2O.

Lung Ultrasound - guided Stepwise PEEP

Volume-controlled ventilation (VCV) mode; with a tidal volume of 6 mL/kg of ideal weight, inspiratory : expiratory ratio 1: 2, PEEP 4 cmH2O, respiratory rate adjusted to keep end-tidal carbon dioxide tension (EtCO2) between 35 and 40 mm Hg, and inspired oxygen fraction of 50%.

Standard Ventilation Protocol

Mustafa E Mohamed, MD

Nazmy S Mikhael, MD

Ashgan R Ali, MD

There is an increasing trend in the use of robotic-assisted radical prostatectomy or cystectomy (RARPC).

Preventing lung atelectasis without inducing overdistention of the lung is challenging. Many studies tried to optimize PEEP titration by using methods such as dead space fraction guided and static pulmonary compliance directed techniques, or by using electrical impedance tomography. However, the use of these methods is limited by inaccuracy and the need for sophisticated devices.

Bedside Lung ultrasound is fast, easy and economic technique that is gaining interest in the operating room. Ultrasound-guided PEEP titration has been used in bariatric surgeries (different position and usually shorter procedure time) and proved effective in improving oxygenation, compliance and reducing the incidence of postoperative pulmonary atelectasis and hypoxia without causing hemodynamic instability.

The aim of this study is to evaluate the effectiveness of intraoperative individualized lung ultrasound-guided stepwise PEEP optimization in patients undergoing RARPC on oxygenation, intraoperative and early postoperative pulmonary complications.

Lung US for PEEP Optimization in Robotic Radical Prostatectomy or Cystectomy Patients

Intraoperative Bedside Lung-ultrasound Use to Optimize Positive End-expiratory Pressure for Elective Robotic-assisted Radical Prostatectomy or Cystectomy Patients: a Randomized Controlled Trial

Presence (or not) of post-operative lung consolidation detected by lung ultrasound.

Nazmy Edward Seif

Clinical Professor

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Lung US for PEEP Optimization in Robotic Radical Prostatectomy or Cystectomy Patients	NCT06307704	Prostate Cancer Urinary Bladder... Surgery Positive End Ex... Lung Ultrasound	Lung Ultrasound... Standard Ventil...	18 Years - 70 Years	Cairo University
Lung US for PEEP Optimization in Robotic Radical Prostatectomy or Cystectomy Patients	NCT06307704	Prostate Cancer Urinary Bladder... Surgery Positive End Ex... Lung Ultrasound	Lung Ultrasound... Standard Ventil...	18 Years - 70 Years	Cairo University
Lung US for PEEP Optimization in Robotic Radical Prostatectomy or Cystectomy Patients	NCT06307704	Prostate Cancer Urinary Bladder... Surgery Positive End Ex... Lung Ultrasound	Lung Ultrasound... Standard Ventil...	18 Years - 70 Years	Cairo University
Lung US for PEEP Optimization in Robotic Radical Prostatectomy or Cystectomy Patients	NCT06307704	Prostate Cancer Urinary Bladder... Surgery Positive End Ex... Lung Ultrasound	Lung Ultrasound... Standard Ventil...	18 Years - 70 Years	Cairo University

Spots Global Cancer Trial Database for positive end expiratory pressure